Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modi...Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modified Branched Graft Inverting (BGI) technique using an inserter under mild hypothermia. We aimed to reduce the surgical duration and to prevent unnecessary damage to the fragile aorta. Methods: We retrospectively reviewed patients with type A acute aortic dissection (AAD) who underwent distal anastomosis via the modified BGI technique using an inserter between January 2012 and March 2013. Open distal anastomosis was performed under mild hypothermia with right hemisphere perfusion from the right axillary artery. Results: Eight patients were enrolled. There was no mortality. Circulatory arrest time was reproducibly 20.3 ± 1.9 min, which was sufficient to complete non-bleeding distal anastomoses. The average rectal temperature during circulatory arrest was 26.5℃ ± 1.9℃. All patients were extubated the day after the operation without any neurological deficit. Conclusion: The modified BGI technique employing an inserter and mild hypothermia offered easy, secure, and reproducible distal anastomosis for ascending aortic replacement for type A acute aortic dissection. Our outcomes were favorable and support further development of this technique.展开更多
Objective To investigate the effect of no-touch harvesting technique in reducing vein graft intimal hyperplasia. Methods This longitudinal trial compared graft angiostenosis of two groups undergoing jugular vein to ca...Objective To investigate the effect of no-touch harvesting technique in reducing vein graft intimal hyperplasia. Methods This longitudinal trial compared graft angiostenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group:12 rabbits had their veins stripped,distended,and stored in heparinized saline solution. No-touch group:12 rabbits had veins removed with surrounding tissues,but were not distended,and stored in heparinized blood. The grafts were removed 4 weeks following grafting,and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness,degree of angiostenosis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P<0.01) compared with those of the conventional group. The proliferating cell nuclear antigen positive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimal hyperplasia of the vein graft.展开更多
AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation.METHODS Pub Med,Web of Science,EMBASE,and the Cochrane...AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation.METHODS Pub Med,Web of Science,EMBASE,and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy(CLDH).Intraoperative and postoperative outcomes(operative time,estimated blood loss,postoperative liver function,length of hospital stay,analgesia use,complications,and survival rate)were analyzed in donors and recipients.Articles were included if they:(1)compared the outcomes of MILDH and CLDH;and(2)reported at least some of the above outcomes.RESULTS Of 937 articles identified,13,containing 1592 patients,met our inclusion criteria and were included in the meta-analysis.For donors,operative time[weighted mean difference(WMD)=20.68,95%CI:-6.25-47.60, =0.13]and blood loss(WMD=-32.61,95%CI:-80.44-5.21, =0.18)were comparable in the two groups.In contrast,analgesia use(WMD=-7.79,9 5%C I:-1 4.0 6-1.8 7, =0.0 1),posto pera tive complications[odds ratio(OR)=0.62,95%CI:0.44-0.89, =0.009],and length of hospital stay(W M D):-1.2 5,9 5%C I:-2.3 5-0.1 4, =0.0 3)significantly favored MILDH.No differences were observed in recipient outcomes,including postoperative complications(OR=0.93,95%CI:0.66-1.31, =0.68)and survival rate(HR=0.96,95%CI:0.27-3.47, =0.95).Funnel plot and statistical methods showed a low probability of publication bias.CONCLUSION MILDH is safe,effective,and feasible for living donor liver resection with fewer donor postoperative complications,reduced length of hospital stay and analgesia requirement than CLDH.展开更多
Direct collection of uranium from low uranium systems via adsorption remains challenging.Fibrous sorbent materials with amidoxime(AO)groups are promising adsorbents for uranium extraction from seawater.However,low AO ...Direct collection of uranium from low uranium systems via adsorption remains challenging.Fibrous sorbent materials with amidoxime(AO)groups are promising adsorbents for uranium extraction from seawater.However,low AO adsorption group utilization remains an issue.We herein fabricated a branched structure containing AO groups on polypropylene/polyethylene spun-laced nonwoven(PP/PE SNW)fibers using grafting polymerization induced by radiation(RIGP)to improve AO utilization.The chemical structures,thermal properties,and surface morphologies of the raw and treated PP/PE SNW fibers were studied.The results show that an adsorptive functional layer with a branching structure was successfully anchored to the fiber surface.The adsorption properties were investigated using batch adsorption experiments in simulated seawater with an initial uranium concentration of 500μg·L^(−1)(pH 4,25℃).The maximum adsorption capacity of the adsorbent material was 137.3 mg·g^(−1)within 24 h;moreover,the uranyl removal reached 96%within 240 min.The adsorbent had an AO utilization rate of 1/3.5 and was stable over a pH range of 4–10,with good selectivity and reusability,demonstrating its potential for seawater uranium extraction.展开更多
Korean larch(Larix olgensis)is one of the main tree species for aff orestation and timber production in northeast China.However,its timber quality and growth ability are largely infl uenced by crown size,structure and...Korean larch(Larix olgensis)is one of the main tree species for aff orestation and timber production in northeast China.However,its timber quality and growth ability are largely infl uenced by crown size,structure and shape.The majority of crown models are static models based on tree size and stand characteristics from temporary sample plots,but crown dynamic models has seldom been constructed.Therefore,this study aimed to develop height to crown base(HCB)and crown length(CL)dynamic models using the branch mortality technique for a Korean larch plantation.The nonlinear mixed-eff ects model with random eff ects,variance functions and correlation structures,was used to build HCB and CL dynamic models.The data were obtained from 95 sample trees of 19 plots in Meng JiaGang forest farm in Northeast China.The results showed that HCB progressively increases as tree age,tree height growth(HT growth)and diameter at breast height growth(DBH growth).The CL was increased with tree age in 20 years ago,and subsequently stabilized.HT growth,DBH growth stand basal area(BAS)and crown competition factor(CCF)signifi cantly infl uenced HCB and CL.The HCB was positively correlated with BAS,HT growth and DBH growth,but negatively correlated with CCF.The CL was positively correlated with BAS and CCF,but negatively correlated with DBH growth.Model fi tting and validation confi rmed that the mixed-eff ects model considering the stand and tree level random eff ects was accurate and reliable for predicting the HCB and CL dynamics.However,the models involving adding variance functions and time series correlation structure could not completely remove heterogeneity and autocorrelation,and the fi tting precision of the models was reduced.Therefore,from the point of view of application,we should take care to avoid setting up over-complex models.The HCB and CL dynamic models in our study may also be incorporated into stand growth and yield model systems in China.展开更多
BACKGROUND: Because of critical organ shortage, transplant professionals have utilized living donor liver transplantation (LDLT) in recent years. We summarized our experience in adult-to-adult LDLT with grafts of righ...BACKGROUND: Because of critical organ shortage, transplant professionals have utilized living donor liver transplantation (LDLT) in recent years. We summarized our experience in adult-to-adult LDLT with grafts of right liver lobe by a modified technique. METHODS: From January 2002 to August 2005, 24 adult patients underwent living donor liver transplantation with grafts of the right liver lobe at West China Hospital, Sichuan University, China. Twenty-two patients underwent modi-Bed procedures designed to improve the reconstruction of the right hepatic vein and the tributaries of the middle hepatic vein by interposing a great saphenous vein ( GSV) graft and the anastomosis of the hepatic arteries and bile ducts. RESULTS: No severe complications and death occurred in all donors. In the first 2 patients, (patients 1 and 2), operative procedure was not modified. One patient suffered from "small-for-size syndrome" and the other died of sepsis with progressive deterioration of graft function. In the rest 22 patients (patients 3 to 24), however, the procedure of venous reconstruction was modified, and better results were obtained. Complications occurred in 7 recipients including acute rejection (2 patients), hepatic artery thrombosis (1), bile leakage (1), intestinal bleeding (1), left sub-phrenic abscess (1), and pulmonary infection (1). One patient with pulmonary infection died of multiple organ failure (MOF). The 22 patients underwent direct anastomosis of the right hepatic vein to the inferior vena cava (IVC), 9 direct anastomosis plus the reconstruction of the right inferior hepatic vein, and 10 direct anastomosis plus the reconstruction of the tributaries of the middle hepatic vein by in-terpos-ing a GSV graft to provide sufficient venous outflow. Trifurcation of the portal vein was met in 3 patients. Venoplasty or separate anastomosis was performed. The ratio of graft to recipient body weight ranged from 0.72% to 1.17%. Among these patients, 19 had the ratio 【1.0% and 4 【0.8%, and the ratio of graft weight to recipient standard liver volume was between 31.86% and 62.48%. Among these patients, 10 had the ratio 【50% and 2 【40%. No "small-for-size syndrome" occurred in the 22 recipients who were subjected to modified procedures. CONCLUSIONS: With the modified surgical techniques for the reconstruction of the hepatic vein to obtain an adequate outflow and provide a sufficient functioning liver mass, living donor liver graft in adults using the right lobe can be safe to prevent the "small-for-size syndrome".展开更多
Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular ane...Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the "bell-bottom" technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the "snorkel and sandwich" technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bellbottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the "snorkel and sandwich" technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications.展开更多
The development of thoracic endovascular aortic repair(TEVAR)technology avoids the risk of patients opening the chest and is widely used in Stanford B-type dissection.[1–3]However,because TEVAR technology has clear r...The development of thoracic endovascular aortic repair(TEVAR)technology avoids the risk of patients opening the chest and is widely used in Stanford B-type dissection.[1–3]However,because TEVAR technology has clear requirements for vascular anatomy of the lesion,it limits its application to some patients.In the shortcomings of the proximal anchor zone,coverage of the left subclavian artery(LSA)origin without revascularization during TEVAR appears to have increased risk of stroke,upper extremity ischemia and paraplegia.[4]展开更多
Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94...Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94-year-old man with an iatrogenic right SCA injury resulting from a misplaced CVC. Computed tomography revealed the catheter piercing the right internal jugular vein to enter the right SCA and then reaching the aortic arch. Emergent endovascular treatment was performed, and a 13-mm × 50-mm self-expanding Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA) was placed via the right brachial artery. The misplaced catheter was successfully removed under simultaneous postdeployment balloon dilatation. This case highlights the utility of the Viabahn stent graft for iatrogenic right SCA injury caused by a misplaced CVC and presents some insights and tips for a safer procedure.展开更多
Background: Achondroplasia is a rare autosomal dominant disorder resulting in skeletal dysplasia. Any injury to the anterior cruciate ligament among people already suffering from achondroplasia results in devastating ...Background: Achondroplasia is a rare autosomal dominant disorder resulting in skeletal dysplasia. Any injury to the anterior cruciate ligament among people already suffering from achondroplasia results in devastating effects. In this report, the outcome of the hamstring graft arthroscopic reconstruction technique for anterior cruciate ligament injury in achondroplasia patients is assessed. The patient in the present case report exhibits the potential for excellent outcomes four months post-surgical follow-up on Lysholm Knee Scoring Scale. This encouraging result, ought to persuade surgeons to use the hamstring graft arthroscopic restoration approach in achondroplasia instances like these. Timely and excellent recovery in such complicated surgical cases, would reduce the obstacle to surgery for several patients with achondroplasia. It would also improve the methods of managing these patients with this particular surgical technique.展开更多
A star-shaped multifunctional styrene-isoprene copolymer was synthesized with n-BuLi as initiator, divinyl benzene as coupling agent, cyclohexane as solvent by living anionic polymerization. Using this polymer as graf...A star-shaped multifunctional styrene-isoprene copolymer was synthesized with n-BuLi as initiator, divinyl benzene as coupling agent, cyclohexane as solvent by living anionic polymerization. Using this polymer as grafting agent, a novel star-shaped branched polymer, containing several polyisobutylene, was prepared via cationic polymerization. The star PS-b-PI and star-branched polyisobutylene were characterized by GPC, 1HNMR and FT-IR, and the effects of different adding order and the amount of grafting agent were investigated.展开更多
文摘Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modified Branched Graft Inverting (BGI) technique using an inserter under mild hypothermia. We aimed to reduce the surgical duration and to prevent unnecessary damage to the fragile aorta. Methods: We retrospectively reviewed patients with type A acute aortic dissection (AAD) who underwent distal anastomosis via the modified BGI technique using an inserter between January 2012 and March 2013. Open distal anastomosis was performed under mild hypothermia with right hemisphere perfusion from the right axillary artery. Results: Eight patients were enrolled. There was no mortality. Circulatory arrest time was reproducibly 20.3 ± 1.9 min, which was sufficient to complete non-bleeding distal anastomoses. The average rectal temperature during circulatory arrest was 26.5℃ ± 1.9℃. All patients were extubated the day after the operation without any neurological deficit. Conclusion: The modified BGI technique employing an inserter and mild hypothermia offered easy, secure, and reproducible distal anastomosis for ascending aortic replacement for type A acute aortic dissection. Our outcomes were favorable and support further development of this technique.
文摘Objective To investigate the effect of no-touch harvesting technique in reducing vein graft intimal hyperplasia. Methods This longitudinal trial compared graft angiostenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group:12 rabbits had their veins stripped,distended,and stored in heparinized saline solution. No-touch group:12 rabbits had veins removed with surrounding tissues,but were not distended,and stored in heparinized blood. The grafts were removed 4 weeks following grafting,and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness,degree of angiostenosis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P<0.01) compared with those of the conventional group. The proliferating cell nuclear antigen positive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimal hyperplasia of the vein graft.
基金Science and Technology Planning Project of Guangzhou,No.201604020001
文摘AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation.METHODS Pub Med,Web of Science,EMBASE,and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy(CLDH).Intraoperative and postoperative outcomes(operative time,estimated blood loss,postoperative liver function,length of hospital stay,analgesia use,complications,and survival rate)were analyzed in donors and recipients.Articles were included if they:(1)compared the outcomes of MILDH and CLDH;and(2)reported at least some of the above outcomes.RESULTS Of 937 articles identified,13,containing 1592 patients,met our inclusion criteria and were included in the meta-analysis.For donors,operative time[weighted mean difference(WMD)=20.68,95%CI:-6.25-47.60, =0.13]and blood loss(WMD=-32.61,95%CI:-80.44-5.21, =0.18)were comparable in the two groups.In contrast,analgesia use(WMD=-7.79,9 5%C I:-1 4.0 6-1.8 7, =0.0 1),posto pera tive complications[odds ratio(OR)=0.62,95%CI:0.44-0.89, =0.009],and length of hospital stay(W M D):-1.2 5,9 5%C I:-2.3 5-0.1 4, =0.0 3)significantly favored MILDH.No differences were observed in recipient outcomes,including postoperative complications(OR=0.93,95%CI:0.66-1.31, =0.68)and survival rate(HR=0.96,95%CI:0.27-3.47, =0.95).Funnel plot and statistical methods showed a low probability of publication bias.CONCLUSION MILDH is safe,effective,and feasible for living donor liver resection with fewer donor postoperative complications,reduced length of hospital stay and analgesia requirement than CLDH.
基金supported by the National Natural Science Foundation of China(Nos.11675247,22176194).
文摘Direct collection of uranium from low uranium systems via adsorption remains challenging.Fibrous sorbent materials with amidoxime(AO)groups are promising adsorbents for uranium extraction from seawater.However,low AO adsorption group utilization remains an issue.We herein fabricated a branched structure containing AO groups on polypropylene/polyethylene spun-laced nonwoven(PP/PE SNW)fibers using grafting polymerization induced by radiation(RIGP)to improve AO utilization.The chemical structures,thermal properties,and surface morphologies of the raw and treated PP/PE SNW fibers were studied.The results show that an adsorptive functional layer with a branching structure was successfully anchored to the fiber surface.The adsorption properties were investigated using batch adsorption experiments in simulated seawater with an initial uranium concentration of 500μg·L^(−1)(pH 4,25℃).The maximum adsorption capacity of the adsorbent material was 137.3 mg·g^(−1)within 24 h;moreover,the uranyl removal reached 96%within 240 min.The adsorbent had an AO utilization rate of 1/3.5 and was stable over a pH range of 4–10,with good selectivity and reusability,demonstrating its potential for seawater uranium extraction.
基金supported by the National Key Research and Development Program of China(2017YFD0600401)the Fundamental Research Funds for the Central Universities(2572019CP08)
文摘Korean larch(Larix olgensis)is one of the main tree species for aff orestation and timber production in northeast China.However,its timber quality and growth ability are largely infl uenced by crown size,structure and shape.The majority of crown models are static models based on tree size and stand characteristics from temporary sample plots,but crown dynamic models has seldom been constructed.Therefore,this study aimed to develop height to crown base(HCB)and crown length(CL)dynamic models using the branch mortality technique for a Korean larch plantation.The nonlinear mixed-eff ects model with random eff ects,variance functions and correlation structures,was used to build HCB and CL dynamic models.The data were obtained from 95 sample trees of 19 plots in Meng JiaGang forest farm in Northeast China.The results showed that HCB progressively increases as tree age,tree height growth(HT growth)and diameter at breast height growth(DBH growth).The CL was increased with tree age in 20 years ago,and subsequently stabilized.HT growth,DBH growth stand basal area(BAS)and crown competition factor(CCF)signifi cantly infl uenced HCB and CL.The HCB was positively correlated with BAS,HT growth and DBH growth,but negatively correlated with CCF.The CL was positively correlated with BAS and CCF,but negatively correlated with DBH growth.Model fi tting and validation confi rmed that the mixed-eff ects model considering the stand and tree level random eff ects was accurate and reliable for predicting the HCB and CL dynamics.However,the models involving adding variance functions and time series correlation structure could not completely remove heterogeneity and autocorrelation,and the fi tting precision of the models was reduced.Therefore,from the point of view of application,we should take care to avoid setting up over-complex models.The HCB and CL dynamic models in our study may also be incorporated into stand growth and yield model systems in China.
文摘BACKGROUND: Because of critical organ shortage, transplant professionals have utilized living donor liver transplantation (LDLT) in recent years. We summarized our experience in adult-to-adult LDLT with grafts of right liver lobe by a modified technique. METHODS: From January 2002 to August 2005, 24 adult patients underwent living donor liver transplantation with grafts of the right liver lobe at West China Hospital, Sichuan University, China. Twenty-two patients underwent modi-Bed procedures designed to improve the reconstruction of the right hepatic vein and the tributaries of the middle hepatic vein by interposing a great saphenous vein ( GSV) graft and the anastomosis of the hepatic arteries and bile ducts. RESULTS: No severe complications and death occurred in all donors. In the first 2 patients, (patients 1 and 2), operative procedure was not modified. One patient suffered from "small-for-size syndrome" and the other died of sepsis with progressive deterioration of graft function. In the rest 22 patients (patients 3 to 24), however, the procedure of venous reconstruction was modified, and better results were obtained. Complications occurred in 7 recipients including acute rejection (2 patients), hepatic artery thrombosis (1), bile leakage (1), intestinal bleeding (1), left sub-phrenic abscess (1), and pulmonary infection (1). One patient with pulmonary infection died of multiple organ failure (MOF). The 22 patients underwent direct anastomosis of the right hepatic vein to the inferior vena cava (IVC), 9 direct anastomosis plus the reconstruction of the right inferior hepatic vein, and 10 direct anastomosis plus the reconstruction of the tributaries of the middle hepatic vein by in-terpos-ing a GSV graft to provide sufficient venous outflow. Trifurcation of the portal vein was met in 3 patients. Venoplasty or separate anastomosis was performed. The ratio of graft to recipient body weight ranged from 0.72% to 1.17%. Among these patients, 19 had the ratio 【1.0% and 4 【0.8%, and the ratio of graft weight to recipient standard liver volume was between 31.86% and 62.48%. Among these patients, 10 had the ratio 【50% and 2 【40%. No "small-for-size syndrome" occurred in the 22 recipients who were subjected to modified procedures. CONCLUSIONS: With the modified surgical techniques for the reconstruction of the hepatic vein to obtain an adequate outflow and provide a sufficient functioning liver mass, living donor liver graft in adults using the right lobe can be safe to prevent the "small-for-size syndrome".
文摘Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the "bell-bottom" technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the "snorkel and sandwich" technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bellbottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the "snorkel and sandwich" technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications.
文摘The development of thoracic endovascular aortic repair(TEVAR)technology avoids the risk of patients opening the chest and is widely used in Stanford B-type dissection.[1–3]However,because TEVAR technology has clear requirements for vascular anatomy of the lesion,it limits its application to some patients.In the shortcomings of the proximal anchor zone,coverage of the left subclavian artery(LSA)origin without revascularization during TEVAR appears to have increased risk of stroke,upper extremity ischemia and paraplegia.[4]
文摘Subclavian artery (SCA) injuries associated with central venous catheter (CVC) insertion are uncommon yet lethal complications that typically require surgical treatment. This case report presents the case of a 94-year-old man with an iatrogenic right SCA injury resulting from a misplaced CVC. Computed tomography revealed the catheter piercing the right internal jugular vein to enter the right SCA and then reaching the aortic arch. Emergent endovascular treatment was performed, and a 13-mm × 50-mm self-expanding Viabahn stent graft (W.L. Gore & Associates, Flagstaff, AZ, USA) was placed via the right brachial artery. The misplaced catheter was successfully removed under simultaneous postdeployment balloon dilatation. This case highlights the utility of the Viabahn stent graft for iatrogenic right SCA injury caused by a misplaced CVC and presents some insights and tips for a safer procedure.
文摘Background: Achondroplasia is a rare autosomal dominant disorder resulting in skeletal dysplasia. Any injury to the anterior cruciate ligament among people already suffering from achondroplasia results in devastating effects. In this report, the outcome of the hamstring graft arthroscopic reconstruction technique for anterior cruciate ligament injury in achondroplasia patients is assessed. The patient in the present case report exhibits the potential for excellent outcomes four months post-surgical follow-up on Lysholm Knee Scoring Scale. This encouraging result, ought to persuade surgeons to use the hamstring graft arthroscopic restoration approach in achondroplasia instances like these. Timely and excellent recovery in such complicated surgical cases, would reduce the obstacle to surgery for several patients with achondroplasia. It would also improve the methods of managing these patients with this particular surgical technique.
文摘A star-shaped multifunctional styrene-isoprene copolymer was synthesized with n-BuLi as initiator, divinyl benzene as coupling agent, cyclohexane as solvent by living anionic polymerization. Using this polymer as grafting agent, a novel star-shaped branched polymer, containing several polyisobutylene, was prepared via cationic polymerization. The star PS-b-PI and star-branched polyisobutylene were characterized by GPC, 1HNMR and FT-IR, and the effects of different adding order and the amount of grafting agent were investigated.
